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DELAWARE Advance Directive Planning for Important Health-Care Decisions

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DELAWARE Advance Directive Planning for Important Health-Care Decisions DELAWARE Advance Directive Planning for Important Health-Care Decisions CaringI nfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice and Palliative Care Organization (NHPCO), is a national consumer engagement initiative to improve care at the end-of-life. It’s About How You LIVE It’s About How You LIVE is a national community engagement campaign encouraging individuals to make informed decisions about end-of-life care and services. The campaign encourages people to: Learn about options for end-of-life services and care Implement plans to ensure wishes are honored Voice decisions to family, friends and health-care providers Engage in personal or community efforts to improve end-of-life care Note: The following is not a substitute for legal advice. While CaringInfo updates the following information and form to keep them up-to-date, changes in the underlying law can affect how the form will operate in the event you lose the ability to make decisions for yourself. If you have any questions about how the form will help ensure your wishes are carried out, or if your wishes do not seem to fit with the form, you may wish to talk to your health-care provider or an attorney with experience in drafting advance directives. If you have other questions regarding these documents, we recommend contacting your state attorney general's office. Copyright © 2005 National Hospice and Palliative Care Organization. All rights reserved. Revised 2020. Reproduction and distribution by an organization or organized group without the written permission of the National Hospice and Palliative Care Organization is expressly forbidden. 1 Using these Materials BEFORE YOU BEGIN 1. Check to be sure that you have the materials for each state in which you may receive health-care. 2. These materials include: • Instructions for preparing your advance directive, please read all the instructions. • Your state-specific advance directive forms, which are the pages with the gray instruction bar on the left side. ACTION STEPS 1. You may want to photocopy or print a second set of these forms before you start so you will have a clean copy if you need to start over. 2. When you begin to fill out the forms, refer to the gray instruction bars — they will guide you through the process. 3. Talk with your family, friends, and physicians about your advance directive. Be sure the person you appoint to make decisions on your behalf understands your wishes. 4. Once the form is completed and signed, photocopy the form and give it to the person you have appointed to make decisions on your behalf, your family, friends, health-care providers and/or faith leaders so that the form is available in the event of an emergency. 5. You may also want to save a copy of your form in an online personal health records application, program, or service that allows you to share your medical documents with your physicians, family, and others who you want to take an active role in your advance care planning. 2 INTRODUCTION TO YOUR DELAWARE ADVANCE HEALTH-CARE DIRECTIVE This packet contains a legal document, the Delaware Advance Health-Care Directive that protects your right to refuse medical treatment you do not want, or to request treatment you do want, in the event you lose the ability to make decisions yourself. Part 1 is a Power of Attorney for Health Care. This part lets you name someone (an agent) to make decisions about your medical care. The Power of Attorney for Health Care becomes effective when your doctor determines that you lack the ability to understand the significant benefits, risks, and alternatives to proposed health care and to make and communicate a health-care decision. Your agent may only make decisions regarding life- sustaining treatment if your doctor and at least one other doctor certify in your medical record that you are also terminally ill or permanently unconscious. Part 2 includes your Instructions for Health Care. This is your state’s living will. It lets you state your wishes about health care in the event that you can no longer speak for yourself and you are terminally ill or you are permanently unconscious. Part 3 allows you to express your wishes regarding organ donation. Part 4 of this form lets you designate a physician to have primary responsibility for your health care. This form does not expressly address mental illness. If you would like to make advance care plans involving mental illness, you should talk to your physician and an attorney about a durable power of attorney. Note: These documents will be legally binding only if the person completing them is a competent adult, who is 18 years of age or older, or an emancipated minor. 3 INSTRUCTIONS FOR YOUR DELAWARE ADVANCE HEALTH-CARE DIRECTIVE How do I make my advance health-care directive legal? Delaware law requires that you sign and date your written advance health-care directive in the presence of two witnesses who are 18 years of age or older. If you are unable to sign the document, another person may sign the document for you in your presence and at your direction. Your witnesses cannot: •r be elated to you by blood, marriage, or adoption, • be entitled to any portion of your estate, • have a claim against any portion of your estate, •r be di ectly financially responsible for your health care, or • be an operator or employee of — or have a controlling interest in — a health-care institution where you are a patient or in which you reside. If you are a resident of a sanitarium, rest home, nursing home, boarding home, or related institution, then one of your witnesses must be a designated patient advocate or ombudsman. Whom should I appoint as my agent? Your agent is the person you appoint to make decisions about your medical care if you become unable to make those decisions yourself. Your agent may be a family member or a close friend whom you trust to make serious decisions. The person you name as your agent should clearly understand your wishes and be willing to accept the responsibility of making medical decisions for you. If you are a resident at a long-term health-care institution, your agent cannot be an operator or employee of or have a controlling interest in the residential long-term health- care institution where you are receiving care, unless that person is related to you by blood, marriage, or adoption. You can appoint a second and third person as your alternate agents. An alternate agent will step in if the person(s) you name as agent is/are unable, unwilling or unavailable to act for you. Should I add personal instructions to my Power of Attorney? One of the strongest reasons for naming an agent is to have someone who can respond flexibly as your medical situation changes and deal with situations that you did not foresee. If you add instructions to this document it may help your agent carry out your wishes, but be careful that you do not unintentionally restrict your agent’s power to act in you r best interest. In any event, be sure to talk with your agent about your future medical care and describe what you consider to be an acceptable “quality of life.” 4 INSTRUCTIONS FOR YOUR DELAWARE ADVANCE HEALTH-CARE DIRECTIVE (CONTINUED) What if I change my mind? You can revoke all or part of your advance health-care directive: •a through signed writing, •c by ompleting a new advance health-care directive, or •n ai ny other manner that communicates your intent to revoke your directive in front of two competent persons, one of whom is a health-care provider. If your revocation is not in writing, someone must put it in writing and must sign and date it in front of two witnesses. Unless you specify otherwise, if you designate your spouse as your agent, that designation will automatically be revoked by divorce, annulment, or dissolution of your marriage or by a filing of a petition for divorce. Are there any important facts I should know? Under Delaware law, a life-sustaining procedure may not be withheld or withdrawn from a patient known to be pregnant, if it is probable that the fetus will survive with the continued application of life-sustaining procedures. 5 DELAWARE ADVANCE HEALTH-CARE DIRECTIVE – PAGE 1 OF 11 EXPLANATION You have the right to give instructions about your own health care. You EXPLANATION also have the right to name someone else to make health-care decisions for you. This form lets you do either or both of these things. It also lets you express your wishes regarding anatomical gifts and the designation of your primary physician. If you use this form, you may complete or modify all or any part of it. You are free to use a different form. Part 1 of this form is a power of attorney for health care. Part 1 lets you name another individual as agent to make health-care decisions for you if you become incapable of making your own decisions. You may also name an alternate agent to act for you if your first choice is not willing, able, or reasonably available to make decisions for you. Unless related to you, an agent may not have a controlling interest in or be an operator or employee of a residential long-term health-care institution at which you are receiving care. If you are not terminally ill or permanently unconsciousness, your agenta m y make all health-care decisions for you except for decisions providing, withholding, or withdrawing of a life- sustaining procedure.
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